Endocrine Abstracts

GH deficiency (GHD) in adults leads to impairment in body composition and function, as well as to deranged lipoprotein and carbohydrate metabolism implying increased cardiovascular morbidity. The morphologic and metabolic alterations in GHD syndrome are more marked in patients with the most severe GHD, even when evaluated by maximal provocative test such as GHRH + arginine. IGF1 synthesis and secretion are function of the GH status but also of major metabolic factors such as i...

ITT is the test of reference for the diagnosis of adult GH deficiency (GHD), but it is recognized that also GHRH in combination with arginine (ARG) or GH secretagogues (GHS) are equally reliable tests. It has also been suggested that testing with GHS would represent a potent stimulus exploring also the integrity of hypothalamic pathways controlling somatotropic function. We therefore aimed to clarify the diagnostic reliability of testing with ghrelin, the natural GHS. We studi...

In acromegalic patients not suitable for first-line surgical treatment, pharmacotherapy is a valuable choice. Depot somatostatin analogs (SSA) represent efficacious and well-tolerated drugs; however, they normalize hormonal parameters in no more than 65–75%. Pegvisomant (PEGA), a GH receptor antagonist, has been shown to normalize IGF-I levels in more than 90% of patients. We report our experience in 13 acromegalic patients (7 M, 6 F; age: 50.2±3.9 yrs; 7 macroadenom...

Introduction: Somatostatin analogues (SSA) are one of the main effective drug used in acromegaly. Sludge and/or cholelithiasis development represents oneof the more common side effect. The aim of the study was to analyze the frequency of biliary adverse events (BAE) and possible predictive factors, to propose a work-up strategy for their management.Method: This is a single centre, longitudinalretrospective study; we enrolled 91 acromegaly patients during...

Objective: Hypopituitarism in adults may be a consequence of TBI, but in the acute or long term management of TBI patients (ptx), endocrine evaluations are not usually included. Aim of this study was to investigate the prevalence of hypopituitarism and metabolic syndrome in a population of 54 severe (n=31) and moderate (n=23) TBI ptx (38 M, 16 F; age (mean±S.D.): 39.8±2.1 years) who had TBI more than 12 months before.<p class="abstext...

Background: When evaluating a patient for central adrenal insufficiency (CAI), there is a wide range of morning cortisol values for which no final conclusion on hypothalamus-pituitary-adrenal (HPA) axis function can be drawn; in these cases, a stimulation test is required. Aim of this study was to develop an integrated model for the prediction of CAI when morning cortisol is in the grey zone, here defined as 40.0-160.0 μg/l.Methods: Overall, 119 pat...

Purpose: The aim of this study was to identify any predictive factors for need of high doses of cabergoline (CAB) in prolactinomas and to study any relationship between adverse events onset and CAB cumulative dose.Methods: Forty-two patients harboring resistant prolactinomas (High Dose group-HD; cabergoline dose ≥ 3.5 mg/week) were matched by gender, age and pituitary tumor diameter at diagnosis with subjects under standard doses (Standard Dose gro...

Introduction: The diagnosis of GH deficiency (GHD) in adults is based on a reduced GH response to provocative tests. The proportion of patients with low GH response to provocative tests increases with the number of other pituitary hormone deficiencies and several studies involving panhypopituitary patients have shown that under certain circumstances GH stimulation tests may be unnecessary to diagnose GHD.Objective: Aim of this study was to re-evaluate th...

Rationale: In the diagnosis of hypopituitarism, the glucagon stimulation test allows for the simultaneous and safe evaluation of the somatotropic and corticotropic axes; recent data have highlighted a stimulating action also on the neurohypophyseal secretion of arginine-vasopressin. This procedure involves the intramuscular or subcutaneous administration of 1-1.5 mg of glucagon based on the patient’s weight (respectively less or more than 90 kg). Nowadays no data are avai...

The potential side effects of the rhGH therapy have been evaluated only during treatment and the accessible databases have been developed as a post-marketing surveillance only by the Companies distributing rhGH. Aim of the present study was to evaluate health consequences (metabolic diseases and/or malignancies) in adults previously treated with rhGH during childhood. We recruited 284 patients (median age at diagnosis 12 years, range 3–17) who underwent rhGH treatment bet...